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Dr. William McPeeters was living in St. Louis, Missouri when the Civil War broke out in 1861. During the 1850s, the citizens of St. Louis became polarized over the slavery issue. Sympathetic to the South, McPeeters was appalled by the anti-Southern sentiments of the abolitionist activists. When the South seceded, he opposed Northern attempts to restore the Union by force. He did not see the issue as slavery, but the ability of a free people to dissolve political ties. When the Federal government imposed martial law on the city of St. Louis, Southern sympathizers were required to sign a loyalty oath, something Dr. McPeeters refused to do. But the handwriting was on the wall and he knew that he would soon face arrest. He fled south of the border, leaving his wife and children in St. Louis, and signed on with the medical department of the Trans Mississippi, Army of the Confederate States of America in 1863.

During his service, McPeeters kept a diary of his experiences, which forms the basis of this book. Like most wartime diaries, he focused on the more pleasant aspects of being on campaign: conversations with comrades, meals, books read, letters from his wife still in St. Louis, church services attended, and reactions to news. He does not go into detail about his work as a surgeon or the conditions under which he worked. His narratives of battle are those of a person who, while in the rear, heard about them after the fact rather than one who experienced it directly. He occasionally describes his more memorable patients, but rarely goes into detail about the number of cases he dealt with on a daily basis. The editors, Cynthia Pitcock and Bill Gurley, include an appendix with five extant reports written by McPeeters to his superiors describing inspections of hospitals he conducted, after-actions report describing medical care he provided to the wounded after battles, and orders he issued. These provide detail of the work he performed, filling in gaps left in the diary of an officer tired of writing such details in official reports and wishing to focus on happier things.

McPeeters turns out to be quite the engaging diarist, his observations enhanced by outstanding endnotes by the editors. The diary survives as a document written during the Civil War, not edited after the fact by the author or by others. The book is subdivided into eleven chapters, each with an excellent overview that puts the diary into historical context. The only glaring flaw in this book is that endnotes of such a high quality as these should have been footnotes that could have been more easily accessed by the reader.

While the historian is not going to get much insight on the tactical aspects of the war in the Trans-Mississippi as McPeeters was far from the command center, the reader will get a sense of his reaction to those situations, off in the distance and out of his control, which guided his destiny. McPeeters reported the rumors and news of the war as he heard them, illustrating how news traveled through the Confederate military. For example, he heard about the fall of Vicksburg two days after the event from Federal officers who stopped by his hospital, but he did not believe the account. The account was confirmed by paroled Confederate prisoners on the 13th of July. The following day, he heard about General Robert E. Lee's defeat at Gettysburg, finding the account hard to believe. When he later heard two conflicting accounts about the fall of Atlanta, possibly accounts about the Battle of Kennesaw Mountain and the Battle of Atlanta, about a week after the battle, he was more circumspect: "We will have to wait and see which account is true. The Yankees are enormous liars and if our account is official for Richmond as it purports to be there is no question as to which is entitled to belief" (p. 194).

One interesting aspect of McPeeters' story is that his wife remained in Union-controlled Missouri while he served in the Confederate Army. Her story is told not only through diary entries of a worried husband describing her correspondence, but also in the overview that precedes each chapter as well as a statement describing her situation written by McPeeters after the war. While McPeeters served, two of his sons died and his wife was investigated, arrested, and expelled as a Confederate sympathizer. His wife's difficulties in keeping the home fires burning were exacerbated by living in enemy territory; the diary thus offers insight into the lives of Confederate sympathizers under Union occupation.

This book is an enjoyable account of one man's service in the Confederate Army. McPeeters' diary is an account of a wartime military surgeon and his family adapting to difficult circumstances. The story, representing his thoughts about and reactions to events as they occurred, is enhanced by well-researched commentary from the editors. It is a book that will be of interest to professional as well as lay historians.